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  • Küçük Resim
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    Clinical and laboratory features of patients with musculoskeletal brucellosis
    (Turkiye Klinikleri, 2005) Aydin, Gülümser; Keleş, İlayda Ceren; Atalar, Ebru; Ayaşlioğlu, Ergin; Tosun, Aliye; Orkun, S.
    Objective: To evaluate the demographic, clinical and laboratory features of patients with musculoskeletal brucellosis in urban and rural areas of Kirikkale, Turkey. Material and Methods: Twenty-eight patients with the diagnosis of musculoskeletal brucellosis were included in the study. All patients were questioned for demographic characteristics, duration and characteristics of complaints and possible source of infection. The findings of detailed systemic and musculoskeletal examinations were noted. Routine blood chemistries, complete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, antinuclear antibody, blood culture and standard tube agglutination tests were carried out. Radiographs of the sacroiliac joints and lumbosacral spine of all patients and, if required, radiographs of peripheral joints were evaluated. Magnetic resonance imaging was performed on those in whom deep joint involvement was suspected clinically and radiographically. Results: Patient mean age was 39.4±14.4 yr, mean duration of disease was 10.1 ± 12.7 yr, and 64.3% of the patients were male. The most frequent symptom was arthralgia (85.7%), and the most prevalent sign was splenomegaly (32.1%). Blood cultures were positive in 39.3% of the patients. Peripheral arthritis had the highest incidence with a rate of 71% in joint manifestations, and the most frequent involvement sites were hip and knee with a ratio of 35%. Sacroiliitis was detected in 32% and was unilateral in 89% of the patients. Spondylitis was found in 14% of the patients, most frequently in lumbar segments (75%). Each musculoskeletal involvement site in terms of all parameters were compared with the others and only the sacroiliac test in the sacroiliitis group and age, vertebral tenderness with percussion and the presence of painful spinal movements in spondylitis group were significantly different from the others (p<0.05). Conclusion: Peripheral joints are the most common articular involvement sites in patients with musculoskeletal brucellosis in our region. Specific sacroiliac joints tests may serve as guides to sacroiliitis. Spinal involvement should be kept in mind in elderly patients with brucellosis, particularly when spinal movements are painful or tenderness is elicited with percussion over the spine. Brucellosis should be included in the differential diagnosis of patients with spinal or peripheral joint pain and in those presenting with complaints due to soft tissue rheumatism. Copyright © 2005 by Türkiye Klinikleri.
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    Diagnosis of osteoarthritic changes, loss of cervical lordosis, and disc space narrowing on cervical radiographs with deep learning methods
    (Turkish Joint Diseases Foundation, 2022) Maras, Yuksel; Tokdemir, Gul; Ureten, Kemal; Atalar, Ebru; Duran, Semra; Maras, Hakan
    Objectives: In this study, we aimed to differentiate normal cervical graphs and graphs of diseases that cause mechanical neck pain by using deep convolutional neural networks (DCNN) technology. Materials and methods: In this retrospective study, the convolutional neural networks were used and transfer learning method was applied with the pre-trained VGG-16, VGG-19, Resnet-101, and DenseNet-201 networks. Our data set consisted of 161 normal lateral cervical radiographs and 170 lateral cervical radiographs with osteoarthritis and cervical degenerative disc disease. Results: We compared the performances of the classification models in terms of performance metrics such as accuracy,
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    Endogenous sex steroids and bone mineral density in healthy men
    (Elsevier France-Editions Scientifiques Medicales Elsevier, 2006) Keles, ışık; Aydin, Gülümser; Basar, M. Murad; Hayran, Mutlu; Atalar, Ebru; Orkun, Sevim; Batislam, Ertan
    Objective. - To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men. Methods. - Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex. steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking. Results. - The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured. Conclusion. - Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD. (c) 2005 Published by Elsevier SAS.
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    Factors affecting bone mineral density in men
    (Springer Heidelberg, 2009) Atalar, Ebru; Aydin, Gülümser; Keleş, Işık; İnal, Elem; Zog, Gulfer; Arslan, Ayşe; Orkun, Sevim
    In this study, in 131 men aged 20-75 years, we investigated correlations between bone mineral density (BMD) in the lumbar spine and femoral neck and endogenous factors (age, body mass index) as well as exogenous factors (calcium intake, physical activity, smoking, caffeine, socioeconomic and educational levels). The age had a negative effect on femoral neck BMD in patients overall, and on both lumbar spine and femoral neck BMD in patients under 50. Physical activity has effects on femoral neck BMD in men above 50. Lumbar vertebral BMD negatively correlated with smoking in patients overall, and this correlation persisted when patients aged 50 and older were analyzed separately. Femoral neck BMD was positively correlated with body mass index in men aged 50 and older. Given the variety of findings in the research literature regarding risk factors for low BMD, we suggest that genetic and geographic factors should be considered.
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    Kadın ve erkeklerde kemik mineral yoğunluğunu üzerine etkili faktörler
    (Kırıkkale Üniversitesi, 2004) Atalar, Ebru; Aydın, Y.Gülümser
    ÖZET Atalar E. Kadın ve erkeklerde kemik mineral yoğunluğu üzerine etkili faktörler. Kırıkkale Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı Uzmanlık Tezi, Kırıkkale, 2004. Değişik coğrafî bölgelerde yaşayan toplumların kemik mineral yoğunluğunda (KMY) farklılıklar görülmektedir. Bu çalışma, yaşadığımız bölgede KMY üzerine etkili faktörleri saptamak amacı ile planlandı. Premenopozal ve postmenopozal olarak gruplandırılan toplam 194 kadın ile 50 yaş altı ve 50 üstü olarak gruplandınlan toplam 131 erkekte, DEXA yöntemi kullanılarak elde edilen lomber vertebra ve femur boynu KMY ölçümlerinin diğer bağımsız değişkenler (erkeklerde yaş, vücut kitle indeksi (VKİ), kalsiyum alımı, fiziksel aktivite, sigara, kafein, alkol, sosyoekonomik düzey, eğitim düzeyi; kadınlarda bu değişkenlere ek olarak gebelik sayısı, laktasyon süresi, menarş yaşı, menopoz süresi ve giyim tarzı) ile olan ilişkisine Spearman's Rho, Pearson r testleri ve Stepwise regresyon yöntemi ile bakıldı. Premenopozal kadınlarda, lomber vertebra ve femur boynu KMY ile VKİ, gebelik sayısı ve eğitim düzeyi arasında anlamlı ilişki saptandı. Postmenopozal kadınlarda lomber vertebra KMY ile kalsiyum alımı, VKİ, toplam laktasyon süresi ve menopoz süresi, femur boynu KMY ile kalsiyum alımı ve menopoz süresi arasında anlamlı ilişki izlendi. Elli yaş altı erkeklerde lomber vertebra ve femur boynu KMY ile kafein alımı arasında anlamlı ilişki gözlendi. Elli yaş üstü erkeklerde lomber vertebra KMY ile sigara kullanımı, femur boynu KMY ile VKİ ve fiziksel aktivite arasında anlamlı ilişki saptandı. Kadın ve erkeklerin doruk kemik mineral yoğunluğuna 30'lu yaşlarda ulaştıkları görüldü. Bu konuda daha sağlıklı bilgiler elde etmek için kapsamlı longitudinal çalışmalara ihtiyaç vardır. Anahtar kelimeler: Kemik mineral yoğunluğu, lomber vertebra, femur boynu.
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    Kas-iskelet sistemi tutulumu olan brusellozisli hastalarda klinik ve laboratuvar özellikler
    (2005) Aydın, Gülümser; Keleş, Işık; Atalar, Ebru; Açıkgöz, Ergin Ayaşlıoğlu; Tosun, Aliye; Orkun, Sevim
    Amaç: Kırıkkale ve kırsalında kas-iskelet sistemi tutulumu olan brusellozisli hastalarda demografik, klinik ve laboratuvar özellikleri incelemek. Gereç ve Yöntemler: Çalışmaya kas-iskelet sistemi tutulumu olan brusellozis tanısı konulmuş 28 hasta dahil edildi. Hastaların demografik özellikleri, yakınmasının süresi, şekli, olası enfeksiyon kaynağı sorgulandı. Ayrıntılı sistemik ve kas-iskelet sistemi muayene bulguları not edildi. Rutin biyokimya, tam kan sayımı, eritrosit sedimentasyon hızı, C-reaktif protein, romatoid faktör, antinükleer antikor, kan kültürü ve standart tüp aglütinasyon testleri yapıldı. Hastaların tümünde sakroiliak, lumbosakral ve gerekli görülen durumlarda periferik eklem radyografileri değerlendirildi. Klinik ve radyografik olarak derin eklemlerin tutulumundan şüphede kalındığı durumlarda magnetik rezonans görüntüleme yönteminden faydalanıldı. Bulgular: Hastaların yaş ortalaması 39.4 ± 14.4 yıl, hastalık süreleri 10.1 ± 12.7 aydı ve %64.3’ü erkekti. En sık izlenen semptom artralji (%85.7), bulgu ise splenomegaliydi (%32.1). Kan kültürü %39.3 hastada pozitifti. Eklem tutulumu olarak periferik artrit %71 oranı ile ilk sıradaydı ve en sık tutulan periferik eklemler %35 ile kalça ve dizdi. Sakroiliit %32 hastada tespit edildi ve %89’u unilateraldi. Spondilit %14 hastada ve en sık lomber segmentte (%75) izlendi. Her bir kas-iskelet sistemi tutulumunun tipi tüm parametreler açısından diğerleri ile kıyaslandığında sakroiliit grubunda sadece sakroiliak testleri pozitifliği, spondiliti olan grupta yaş, perküsyonla vertebra hassasiyeti ve spinal hareketlerle ağrının varlığı, diğerlerinden anlamlı düzeyde farklıydı (p< 0.05). Sonuç: Bölgemizde brusellozis saptanan ve aynı zamanda kas-iskelet sistemi tutulumu olan olgularda en sık tutulum periferik eklemlerde izlenmektedir. Sakroiliak ekleme yönelik özel testler sakroiliit için yol gösterici olabilir. Özellikle spinal hareketleri ağrılı ve perküsyonla hassasiyet saptanan brusellozisli yaşlı hastalarda omurga tutulumu olabileceği akılda tutulmalıdır. Spinal ya da periferik eklem ağrısı olan ve yumuşak doku romatizmasına bağlı şikayeti bulunan hastalarda brusellozis ayırıcı tanıda yer almalıdır.
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    Laser Therapy in Knee Osteoarthritis: An Experimental Study
    (Gazi Univ, Fac Med, 2022) Ozbay, Kadri Koray; Atalar, Ebru; Karahan, Siyami; Orkun, Sevim; Ide, Tayfun; Tugcu, Ilknur; Sezer, Refia
    Aim: In this study, it is aimed to examine the effects of Infrared Gallium-Arsenic (Ga-Ar) laser therapy in rat osteoarthritis (OA) model that is formed chemically on the knee joint cartilage. Material and methods: Fifty-six female Wistar Albino rats having weights between 250 and 300 grams were used and the rats were divided in 3 groups. Group 1 and group 2 are the control (C) groups. In group 1 (C-1), 0.9% saline solution was aplied to the left knee joint of 32 rats and in group 2 (C-2), 1 mg monoiodoacetate (MIA) is applied to the right knee joint of the same 32 rats. Group 3 is the experimental (E) group and in this group, 1 mg MIA application to the right knees of 24 rats. Ga-Ar laser therapy was started after 24 hours for group 3 and it was applied for 15 days with 24-hour intervals. In all 3 groups, knee bending test was applied daily. Euthanasia was applied on 1st,7th and 15th days to 8 rats in C-1 and C-2 and on 7th, 15th and 30th days to 8 rats in group E. Their knee joints were removed, and they were histopathologically assessed under a light microscope. Results: As a result of the statistical assessment, in the assessment between the total scores between C-1 and C-2 groups, scores of the C-2 group were found higher at all the time points (p=0.001, p=0.002). Also when the E and C-2 groups were compared, no statistically significant difference was observed (p>0.05). There was no correlation between the pain assessment of knee bending test and the level of histopathological findings. Conclusions: We found no effect of laser therapy in the treatment of early knee osteoarthritis.
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    Predictive value of grip strength for bone mineral density in males: site specific or systemic?
    (Springer Heidelberg, 2006) Aydın, Gülümser; Atalar, Ebru; Keleş, Işık; Tosun, Aliye; Zog, Gülfer; Keleş, Hatice; Orkun, Sevim
    This study aimed to investigate the predictive role of grip strength on bone mineral density (BMD) of different sites in males. Two hundred thirty-four male patients were included in the study. BMD of lumbar spine, femoral neck, proximal radius-ulna (PRU) and distal radius-ulna (DRU) sites were measured by dual-energy X-ray absorptiometry and grip strength by using a hand dynamometer. Grip strength and BMD values of PRU and DRU at forearms were significantly higher on the dominant sides (P = 0.001, P = 0.001, P = 0.001, respectively). Stepwise linear regression analysis revealed that only the grip strength of the same side was the best predictor of the BMD of the dominant and non-dominant PRU with a ratio of 8.5 and 10.2%, respectively, whereas grip strength of the same side, age and weight were the best predictors of the BMD of the dominant and non-dominant DRU with a ratio of 25 and 24.6%, respectively. There was no predictive value of grip strength for BMD of lumbar spine and femoral neck. In conclusion, grip strength appears to be predictive of site specific rather than systemic BMD.